Provider Demographics
NPI:1437019171
Name:CHANDRASEKARAN, SUKANTHA (PHD, D(ABMM))
Entity type:Individual
Prefix:
First Name:SUKANTHA
Middle Name:
Last Name:CHANDRASEKARAN
Suffix:
Gender:F
Credentials:PHD, D(ABMM)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11633 SAN VICENTE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-6511
Mailing Address - Country:US
Mailing Address - Phone:310-794-2722
Mailing Address - Fax:
Practice Address - Street 1:11633 SAN VICENTE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-6511
Practice Address - Country:US
Practice Address - Phone:310-794-2722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-14
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01015390207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine